关注IHE关键影像标记在PACS中的应用

关键影像标记通过指定一组事务处理的定义,将影像检查序列中一帧或多帧关键影像与其对应的注释信息进行关联。本文对该集成模型的角色、事务处理以及相关的DICOM内容进行了分析。     

Benefits of the DICOM Structured Report

Recently, the digital imaging and communications in medicine (DICOM) standard introduced rules for the encoding, transmission, and storage of the imaging diagnostic report. This medical document can be stored and communicated with the images in picture archiving and communication system (PACS). It is a structured document that contains text with links to other data such as images, waveforms, and spatial or temporal coordinates. Its structure, along with its wide use of coded information, enables the semantic understanding of the data that is essential for the Electronic Healthcare Record deployment. In this article, we present DICOM Structured Report (SR) and discuss its benefits. We show how SR enables efficient radiology workflow, improves patient care, optimizes reimbursement, and enhances the radiology ergonomic working conditions. As structured input significantly alters the interpretation process, understanding all its benefits is necessary to support the change. Biography Rita Noumeir is a professor at the Department of Electrical Engineering of the University of Quebec, école de Technologie Superieure in Montreal. A founding member of the Imaging, Vision, and Artificial Intelligence Laboratory (LIVIA), her main research interest is the Healthcare Information Technology, specifically, Interoperability, Electronic Patient Record, Security, Information Confidentiality, and Image Processing. As a member of both Technical and Planning International IHE Radiology Committees, Dr. Noumeir took part over the last 5 years in developing many Integrating the Healthcare Enterprise (IHE) Integration Profiles in Radiology and in organizing several Integration Demonstrations. She is a cofounder of IHE Canada. Dr. Noumeir contributed to many research and development projects in collaboration with several Canadian and international companies in medical imaging and healthcare information. Currently, she collaborates with the Diagnostic Imaging Team of Canada Health Infoway to define the principles and architecture for sharing imaging information between multiple healthcare institutions. She plays a leading role in the development of this solution that is published as an IHE Integration Profile for which she is the editor. Rita Noumeir holds a Ph.D. and a Masters degree in Biomedical Engineering from école Polytechnique of Montreal specializing in Medical Imaging. She is a professional engineer, and a member of the Ordre des ingénieurs du Québec.     

Benefits of the DICOM Modality Performed Procedure Step

A few years ago, the Digital Imaging and Communications in Medicine standard introduced a network transaction that is initiated by modality equipment, mainly at the beginning and at the end of the acquisition. This transaction, the Modality Performed Procedure Step (MPPS), is sent to the Picture Archiving and Communication System and/or to the Radiology Information System. It carries information about what really has been performed by the modality equipment during acquisition. In this paper, we present MPPS and discuss its benefits. We show how MPPS enables efficient radiology workflow and how it ensures accuracy and completeness of imaging information. We think our paper helps bridge the gap between MPPS implementation and deployment. By understanding all the MPPS benefits, the end user becomes aware of the great enhancement in patient care that this transaction provides.     

论坛专题报告之二 Employing Industry Standards for System Integration in Digital Radiology Department

１．INTRODUCTIONSincethepastdecade熏RadiologyInformationSystem穴RIS雪andPictureArchivingandCommunicationSys鄄tem穴PACS雪havebeingemployedinanincreasednumberofradiologyde鄄partmentstoimproveprocesspro鄄ductivity熏providebetterqualityofimagingservices熏andreducemedicalerrors．Intherecentyears熏systemin鄄tegrationhasbecomethemajorneedofthehealthcareprovidersworld鄄wide熏todrivethedirectionofthede鄄velopmentofRISandPACStowardsafullyintegrateddigitalradiologyde鄄partment．Openindustrys…     

The value of susceptibility-weighted imaging (SWI) in patients with non-neonatal hypoxic-ischemic encephalopathy

ObjectiveIn susceptibility-weighted imaging (SWI) in the normal brain, cortical veins appear hypointense due to paramagnetic properties of deoxy-hemoglobin. Global cerebral anoxia decreases cerebral oxygen metabolism, thereby increasing oxy-hemoglobin levels in cerebral veins. We hypothesized that a lower cerebral oxygen extraction fraction in comatose patients with non-neonatal hypoxic-ischemic encephalopathy (IHE) produces a pattern of global rarefied or pseudo-diminished cortical veins due to higher oxy-hemoglobin.Purpose(1) To investigate the topographic relationship between susceptibility effects in cortical veins and related diffusion restrictions on diffusion-weighted imaging (DWI) in patients with IHE. (2) To relate imaging findings to patterns of altered resting activity on surface EEG.MethodsTwenty-three IHE patients underwent MRI. EEG patterns were used to classify the depth of coma. Regional vs. global susceptibility changes on SWI and patterns of DWI restrictions were compared with the depth of coma.ResultsAll patients exhibited areas of restricted cortical diffusion and SWI abnormalities. The dominant DWI restrictions encompassed widespread areas along the precuneus, frontal and parietal association cortices and basal ganglia. For SWI, nineteen patients had generalized bi-hemispherical patterns, the EEG patterns correlated with coma grades III–V. Four patients had focal decreases of deoxy-hemoglobin following DWI restrictions; associated with normal EEGs.ConclusionFocal patterns of diamagnetic effects on SWI according to relative decreases in deoxy-hemoglobin due to reduced metabolic demand are associated with normal EEG in IHE patients. Global patterns indicated increased depth of coma and widespread cortical damage.Clinical relevanceThe results indicate a potential diagnostic value of SWI in patients with IHE.     

基于 IHE 医学影像信息系统的优化与实践简

目的优化医学影像检查的工作流程,促进信息系统的无缝集成。方法从IHE集成模式的预定工作流程集成模式入手,对医院PACS建设在IHE 集成模式开展与应用情况进行回顾与分析,并对传统工作流程进行改造与优化。结果基于IHE标准集成模式RIS与PACS的一体化集成,不仅使影像部门的工作流更加流畅,而且使数据流更加平滑。结论基于IHE医学影像信息系统,可以充分利用有限资源,缩短病人检查的周转时间,提高医疗服务质量。     

集团医院Enterprise-PACS构建思维

随着集团医院逐步成为一种新型有效的医疗健康服务模式以及区域化信息服务需求的增长,Enterprise-PACS正在成为新一代医学信息网络发展和应用的一支生力军。在我国,E-PACS的应用处于起步阶段。2005年5月我院集团医院E-PACS项目开始启动。在经历一年国外文献复习、大量现场调研以及结合我院实情的需求分析后,项目规划、设计及实施方案初步形成。今年底之前,该E-PACS项目将投入实施。本文就E-PACS背景、构建策略以及挑战进行讨论。     

PACS在我院的建设和应用

目的:通过构建医学影像与传输系统(PACS),实现医院医学影像信息工作的管理和服务的数字化网络。方法:根据医院的特点,进行整体的规划,采用适合的系统架构和单元设计,逐步予以实施。结果:目前已完成全部建设任务,并对系统进行不断地测试,使其更加完善,同时进行了一些临床应用。结论:我院PACS 2 a来运行的结果表明,该系统性能稳定,达到了设计和实际运行的要求。     

集成医疗卫生企业（IHE）的集成性声明文档

IHE集成性声明文档是一份由IHE提供商撰写并公开发布的关于其产品符合IHE技术框架（Technical Framework）程度的遵从性文件.本文对该文档的结构,内容和组成格式进行了说明,以帮助国内医院信息集成商及广大医疗卫生系统用户进一步学习理解.     

异构PACS间互操作的方法研究

目的 建立数字医学影像平台,解决异构PACS间数据的互操作性问题.方法 基于医学影像数据交互的业务特点,设计了分层的系统架构,对业务流程进行了标准化.结果 构建合理的区域医学影像平台的模型,为实现影像数据的互操作提供了懈决方法.结论 设计方案灵活可扩展性强,减少了医疗数据区域化互操作的成本,提高数据的可管理性及有效性.